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Pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival
BACKGROUND/AIMS: We investigated whether transthoracic echocardiography-suspected pulmonary hypertension (PH) affects survival in systemic lupus erythematosus (SLE) patients and examined factors associated with PH occurrence and survival. METHODS: This retrospective single-center study included 154...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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The Korean Association of Internal Medicine
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351331/ https://www.ncbi.nlm.nih.gov/pubmed/25750566 http://dx.doi.org/10.3904/kjim.2015.30.2.232 |
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author | Min, Hong Ki Lee, Jae Ho Jung, Seung Min Lee, Jennifer Kang, Kwi Young Kwok, Seung-Ki Ju, Ji Hyeon Park, Kyung-Su Park, Sung-Hwan |
author_facet | Min, Hong Ki Lee, Jae Ho Jung, Seung Min Lee, Jennifer Kang, Kwi Young Kwok, Seung-Ki Ju, Ji Hyeon Park, Kyung-Su Park, Sung-Hwan |
author_sort | Min, Hong Ki |
collection | PubMed |
description | BACKGROUND/AIMS: We investigated whether transthoracic echocardiography-suspected pulmonary hypertension (PH) affects survival in systemic lupus erythematosus (SLE) patients and examined factors associated with PH occurrence and survival. METHODS: This retrospective single-center study included 154 Korean SLE patients fulfilling the American College of Rheumatology criteria (January 1995 to June 2013). Student t test, Mann-Whitney U test, Kaplan-Meier curves, and log-rank tests were used for comparisons. RESULTS: A total of 35 SLE patients with PH (SLE/PH+) and 119 without PH (SLE/PH-) were analyzed. Higher percentages of interstitial lung disease, Raynaud's phenomenon (RP), World Health Organization functional classification III/IV, and cardiomegaly were found in SLE/PH+ compared to SLE/PH-. Furthermore, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index was significantly higher in SLE/PH+ (2.46 ± 1.245 vs. 1.00 ± 1.235), whereas survival rates were significantly higher in SLE/PH- in log-rank tests (p = 0.001). In multivariate analysis, the adjusted mortality hazard ratio (HR) for SLE/PH+ patients was 3.10. Subgroup analysis demonstrated a higher percentage of lupus nephritis in the SLE/PH+ patients who died (p = 0.039) and low complement-3 levels (p = 0.007). In univariate analysis, the mortality HR for SLE/PH+ patients with lupus nephritis was 4.62, whereas the presence of RP decreased the mortality risk in multivariate analysis; adjusted HR, 0.10. CONCLUSIONS: PH is an independent factor predicting survival in SLE patients. The presence of lupus nephritis resulted in an increased trend for mortality, whereas coexistence of RP was associated with a better survival prognosis in SLE/PH+ patients. |
format | Online Article Text |
id | pubmed-4351331 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | The Korean Association of Internal Medicine |
record_format | MEDLINE/PubMed |
spelling | pubmed-43513312015-03-06 Pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival Min, Hong Ki Lee, Jae Ho Jung, Seung Min Lee, Jennifer Kang, Kwi Young Kwok, Seung-Ki Ju, Ji Hyeon Park, Kyung-Su Park, Sung-Hwan Korean J Intern Med Original Article BACKGROUND/AIMS: We investigated whether transthoracic echocardiography-suspected pulmonary hypertension (PH) affects survival in systemic lupus erythematosus (SLE) patients and examined factors associated with PH occurrence and survival. METHODS: This retrospective single-center study included 154 Korean SLE patients fulfilling the American College of Rheumatology criteria (January 1995 to June 2013). Student t test, Mann-Whitney U test, Kaplan-Meier curves, and log-rank tests were used for comparisons. RESULTS: A total of 35 SLE patients with PH (SLE/PH+) and 119 without PH (SLE/PH-) were analyzed. Higher percentages of interstitial lung disease, Raynaud's phenomenon (RP), World Health Organization functional classification III/IV, and cardiomegaly were found in SLE/PH+ compared to SLE/PH-. Furthermore, the Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index was significantly higher in SLE/PH+ (2.46 ± 1.245 vs. 1.00 ± 1.235), whereas survival rates were significantly higher in SLE/PH- in log-rank tests (p = 0.001). In multivariate analysis, the adjusted mortality hazard ratio (HR) for SLE/PH+ patients was 3.10. Subgroup analysis demonstrated a higher percentage of lupus nephritis in the SLE/PH+ patients who died (p = 0.039) and low complement-3 levels (p = 0.007). In univariate analysis, the mortality HR for SLE/PH+ patients with lupus nephritis was 4.62, whereas the presence of RP decreased the mortality risk in multivariate analysis; adjusted HR, 0.10. CONCLUSIONS: PH is an independent factor predicting survival in SLE patients. The presence of lupus nephritis resulted in an increased trend for mortality, whereas coexistence of RP was associated with a better survival prognosis in SLE/PH+ patients. The Korean Association of Internal Medicine 2015-03 2015-02-27 /pmc/articles/PMC4351331/ /pubmed/25750566 http://dx.doi.org/10.3904/kjim.2015.30.2.232 Text en Copyright © 2015 The Korean Association of Internal Medicine http://creativecommons.org/licenses/by-nc/3.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Min, Hong Ki Lee, Jae Ho Jung, Seung Min Lee, Jennifer Kang, Kwi Young Kwok, Seung-Ki Ju, Ji Hyeon Park, Kyung-Su Park, Sung-Hwan Pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival |
title | Pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival |
title_full | Pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival |
title_fullStr | Pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival |
title_full_unstemmed | Pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival |
title_short | Pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival |
title_sort | pulmonary hypertension in systemic lupus erythematosus: an independent predictor of patient survival |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351331/ https://www.ncbi.nlm.nih.gov/pubmed/25750566 http://dx.doi.org/10.3904/kjim.2015.30.2.232 |
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